Nosocomial CCHF Cluster In Punjab, Pakistan - NOT

[alert]

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85086

Archive Number 20100930.3547
Published Date 30-SEP-2010
Subject PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (03): (PB) nosocomial


CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (03): (PUNJAB) NOSOCOMIAL
********************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 30 Sep 2010
Source: Dawn.com, Islamabad [edited]
<http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/the-newspaper/local/islamabad/eight-hospital-employees-contract-congo-virus-090>


4 female doctors and as many other staff members have contracted the
deadly Crimean-Congo Haemorrhagic Fever (CCHF) virus at the Holy
Family Hospital [HFH], setting alarm bells ringing in the city and the
health department to take preventive measures to avoid further
outbreaks of the disease.

Doctors at the hospital told Dawn on Wednesday [26 Sep 2010] that
blood samples of 4 female doctors, 2 nurses, one student nurse and a
ward boy sent to the National Institute of Health (NIH) had been
confirmed positive for the infection. The doctors and staff have been
shifted to the Intensive Care Unit (ICU) for treatment.

The doctors contracted the infection while dealing with 2 patients
being treated at the hospital. One patient had been brought to the HFH
on Tue 14 Sep 2010 and later moved to the Shifa International
Hospital, Islamabad [see: ProMED-mail post: Crimean-Congo hem. fever -
Pakistan (03): (PB) 20100923.3440]. Another CCHF patient died at Holy
Family Hospital on Fri 24 Sep 2010, 2 days after being admitted there.
The HFH administration has sent blood samples of its staff members to
the NIH as precautionary measures.

Dr Javed Hayyat, who is supervising treatment of the patients, told
Dawn that the female doctors were feeling well and there were no
symptoms of CCHF; however, the 2 nurses were suffering from fever. He
said the doctors [are believed to have] contracted the virus during
the past 12 days. "No symptoms were developed, and the said virus [was
no longer evident] after 2 weeks, if the patient had not [exhibited]
fever," he said.

When contacted, HFH Medical Superintendent Capt. (retired) Dr Fayyaz
confirmed that blood tests on the 8 staff members were positive for
CCHF. "We had sent the blood samples of those dealing with the CCHF
patients to NIH, and these 8 have tested positive for the viral
disease," he said.

He said only 2 nurses had developed symptoms; however, the symptoms
had not developed in the female house officers. "After consultation
with Rawalpindi Medical College Principal Dr Afzal Farooqui and other
senior specialists, we have started treatment [ribavirin treatment?]
of the patients," he said. He said further blood samples from the 8
patients had been dispatched to the NIH.

CCHF haemorrhagic fever is a zoonotic disease that animals [transmit]
to humans. In Pakistan, the 1st human outbreak [of CCHF] was reported
in 1976 at Rawalpindi, when a doctor died while treating a patient at
the Central General Hospital (now Benazir Bhutto Hospital). A
25-year-old intern physician also died at Holy Family Hospital in 2002
while treating a Congo fever patient.

[Byline: Aamir Yasin]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[It is unclear whether there is any connection between these patients
in Rawlpindi and the patients with an undiagnosed illness, which may
be CCHF, now under treatment in the neighboring province of
Khyber-Pakhtunkhwa (formerly North-West Frontier Province) and the
single CCHF patient under treatment in Karachi (Sindh province).
Clarification would be welcomed.

In view of the past tragic history of nosocomial cases of CCHF in
Pakistani hospitals, it is surprising that there has not been greater
awareness of the danger of nosocomial infection. It may be that this
is another unfortunate consequence of the devastation associated with
the recent flooding throughout the Indus valley.

The HealthMap/ProMED-mail interactive map of Pakistan, accessible at
<http://healthmap.org/r/00tj>, can be used to locate the provinces of
Khyber-Pakhtunkhwa, Punjab and Sindh. - Mod.CP]

[I find this report confusing; the 4 doctors are said to be in the
ICU, but the "house officers" -- presumably the same doctors -- had no
symptoms; in which case, why are they there and why were their blood
specimens sent for testing? Perhaps they are there in lieu of a
quarantine ward, and are being tested & treated preventively. I also
find it sad that hospital staff are so uninformed about CCHF cases
occurring in other states of their country -- don't they read the
newspapers or ProMED? -- and apparently do not take the proper
precautions when treating a patient with a hemorrhagic disease. -
Mod.JW]

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

This is the original article.

http://www.dawn.com/wps/wcm/connect...t-hospital-employees-contract-congo-virus-090

Eight hospital employees contract Congo virus By Aamir Yasin
Thursday, 30 Sep, 2010 MEDIA GALLERY
Across the water RAWALPINDI, Sept 29: Four female doctors and as many other staff members have contracted the deadly Crimean-Congo Haemorrhagic Fever (CCHF) virus at the Holy Family Hospital, setting alarm bells ringing in the city and the health department to take preventive measures to avoid further outbreak of the disease.

Doctors at the hospital told Dawn on Wednesday that blood samples of four female doctors, two nurses, one student nurse and a ward boy sent to the National Institute of Health (NIH) had been confirmed positive for the infection. The doctors and staff have been shifted to the Intensive Care Unit (ICU) for treatment.

They said the names of doctors were Sonia, Adeela Naseer, Maryam Kamran and Irum Najeem. The nurses are: Shazia Parveen, Ulfat Parveen, Maryum Noor (student nurse) and Mohammad Mushtaq, ward boy.

The doctors contracted the infection while dealing with two patients - Rasheeda Begum and Taufeeq Ahmed - at the hospital.

Rasheeda was brought to HFH on September 14 and later shifted to Shifa International Hospital, Islamabad. Another CCHF patient, Taufeeq Ahmed, died at Holy Family Hospital on September 24 two days after being admitted there.

The HFH administration had sent the blood samples of its staff members to the NIH as precautionary measures.

Dr Javed Hayyat, who is supervising treatment of the patients, told Dawn that the female doctors were feeling well as there were no symptoms of CCHF; however, the two nurses were suffering from fever. He said according to the report the doctors had contracted the virus during the last 12 days. ?No symptoms were developed and the said virus died automatically after two weeks if the patient did not suffer from fever,? he said.

When contacted, HFH Medical Superintendent Capt (retired) Dr Fayyaz confirmed that blood tests on the eights staff members were positive of the Congo fever. ?We had sent the blood samples of those dealing with the CCHF patients to NIH and these eight have been tested positive for the viral disease,? he said.

He said only two nurses had developed symptoms; however, the symptoms had not developed in the female house officers. ?After consultation with Rawalpindi Medical College Principal Dr Afzal Farooqui and other senior specialists, we have started the treatment of the patients,? he said.

He said further blood samples of the eight patients had been dispatched to the NIH.

The viral haemorrhagic fever belongs to Zoonotic diseases that animals cause to humans. In Pakistan, the first human outbreak was reported in 1976 at Rawalpindi when Dr Mateen died while treating a patient at the Central General Hospital (now Benazir Bhutto Hospital).

A 25-year-old intern physician, Dr Farzana, also died at Holy Family Hospital in 2002 while treating a Congo fever patient.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

http://www.dailytimes.com.pk/default.asp?page=2010\10\01\story_1-10-2010_pg11_8

2nd Congo patient dies at HFH in 2 weeks

RAWALPINDI: A woman died of Congo virus at the night between Wednesday and Thursday at Holy Family Hospital (HFH). She was the second victim of Congo virus in two weeks. HFH spokesman confirmed to Daily Times death of Tahira, 42, who had high fever and bleeding from nose, mouth and other parts of body. She was brought to hospital from Pindi Gheb on Wednesday evening in extremely critical situation. She was kept in isolation in intensive care unit (ICU). Earlier on September 24, a patient Taufeeq, also from Pindi Gheb, died of Congo virus in the same hospital.

The hospital administration has sent blood samples of Tahira for their medical analysis to National Institute of Health to verify the cause of her death.

Rashida Bibi of Pindi Gheb was treated for Congo virus at Al-Shifa Hospital and she reportedly recovered. The spokesman said five patients of Dengue fever are also kept separately in the hospital but their condition is stable.

He said after arrival of Congo virus patients, a ward has been separated for them. Seven staff members of the hospital including nurses and doctors are also suspected of carrying the viral symptoms. ?These doctors and nurses will be kept under observation for 14 days to ensure their timely treatment,? he said.

High-ups in the Health Department are considering sending a medical team to Pindi Gheb to prevent feared outburst of the disease. staff report

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

The patients named Toseef and Taufeeq are likely the same person. There is some confusion though, as to the patients, as some reports indicate that Rahida (35) has recovered, and others indicate that she has died. And I'm not sure where Tahira (42) comes in.

http://www.nation.com.pk/pakistan-n...0/Five-HFH-doctors-3-nurses-catch-Congo-virus

Five HFH doctors, 3 nurses catch Congo virus
By: Israr Ahmed | Published: September 30, 2010
PrintFacebookDiggStumbleUponText Size
RAWALPINDI – Five doctors, including four female doctors, and three nurses of Holy Family Hospital (HFH) suffering from Congo virus have been admitted in a special isolation ward and are receiving medical treatment.
The female doctors of HFH Sonia, Adeela Naseer, Mayram Kamran and Iram Najib and staff nurses Shazia Perven, Ulfat Perven and Maryam Noor were affected by Congo virus while giving medical treatment to two Congo virus patients Rahida Bibi and Toseef, hailing from Attock, brought HFH a week ago, sources informed TheNation here on Wednesday.
A male doctor of HFH is also affected by Congo virus but his name has been kept secret by hospital administration, sources further told.
Talking to the newsmen, HFH Spokesman Dr Raja Shafique Sarwar said that the patients contained suspected symptoms of Congo virus and added that all the doctors and nurses were admitted in a special isolation ward and were receiving treatment. He further said that the blood samples of the patients have been sought and would be sent to Islamabad for clinical tests.
Sources also claimed that one patient Toseef had died on Monday suspected of Crimean-Congo Hemorrhagic Fever while Rashida Bibi died on Wednesday at 6:10pm.
Emergency has been declared at the HFH and the new private ward has been declared as isolation area, where at present five doctors and three nurses have been kept, sources added.
All necessary measures as per protocol have been undertaken. The situation is under control and is being watched very closely, HFH MS Dr Fayyaz told TheNation.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

I am not aware of asymptomatic CCHF infection. Odd. Perhaps the test was contaminated?

http://www.thenews.com.pk/30-09-2010/islamabad/7419.htm

Four lady doctors, 3 nurses at HFH confirmed positive with infection



Muhammad Qasim
Rawalpindi
As many as seven health professionals including four lady doctors and three staff nurses serving at Holy Family Hospital have been confirmed positive for Crimean-Congo Haemorrhagic Fever (CCHF) by the National Institute of Health, Islamabad.
According to details, the seven health professionals were involved in treatment of a suspected CCHF case namely Rasheeda Begum, aged 35 who was brought to Holy Family Hospital, Rawalpindi, on September 14 from Village Toot, Dhoke Golguppa of Tehsil Pindigheb, Attock. The HFH sent her blood sample to the NIH, which declared the patient positive for the infection on September 20.
Rasheeda Begum reached HFH with high-grade fever and continued, uncontrolled nasal and throat bleeding while bleeding from her skin and rectum was also reported. Later she was moved to Shifa International Hospital, Islamabad, by her attendants on September 16 where she started getting stable.
‘The News’ learnt on Wednesday that four lady doctors and three staff nurses who were involved in treatment of Rasheeda Begum at Holy Family Hospital have been confirmed positive for the infection by the NIH, however, none of them has so far developed any symptoms of the CCHF.
Official spokesman of the HFH Dr Raja Shafiq Sarwar, when
contacted by ‘The News’ Wednesday confirmed the report saying that none of the seven health professionals has so far developed any symptoms of the infectious disease.“We have sent their blood samples to the NIH as a precautionary measure that declared them positive for the infection,” said Dr Shafiq Sarwar.
Studies reveal that Viral Haemorrhagic Fever family including Crimean-Congo Haemorrhagic Fever and Ebola are zoonotic diseases that animals cause to humans. The mortality rate of like haemorrhagic fevers ranges from 50 to 90 per cent. Persons with the infection of this virus family experience headache, high fever, muscle pain and vomiting along with internal and external bleeding.
CCHF is highly infectious disease. It is important that nearly seven years ago Dr. Farzana Altaf of Holy Family Hospital died after developing CCHF while treating a CCHF patient. Earlier, some three decades back, a renowned health professional in town Dr Mateen also died of the infection while trying to treat a CCHF patient.
It is important that the HFH administration had claimed that its staff had taken proper care while handling Rasheeda Begum, however, the confirmation of seven health professionals at the hospital for CCHF hints that proper care was not taken.
When asked, Dr Shafiq said that they have not kept any of the infected health professionals in isolation, as they have not developed any symptoms of CCHF so far. He, however, said that the infected health professionals are under surveillance.
On the other hand, a few health professionals opine that the doctors and nurses tested positive for CCHF should remain in isolation as a precautionary measure.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

This is the thread for the undiagnosed illness mentioned in the ProMED post that may be CCHF, Dengue, or a combination of both, or something else. There do not appear to be any epidemiological links between this cluster and those outbreaks.

http://www.flutrackers.com/forum/showthread.php?p=373210

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

These sources are extremely poor, so it is difficult to compare information, but there may have been three suspected CCHF patients treated in that hospital, not just two.

It looks like Rasheeda/Rashida (35) was treated at HFH, but transferred to another hospital and is still alive and recovering (as in http://pakistannewsblog.com/congo-fever-patient-in-stable-condition-at-shifa/ , although one article does report her death in HFH - Odd). Tahira (42) and Taufeeq (male, age unknown) appear to have died in that hospital.

In terms of geography, Pindi Gheb appears to be about 50 miles from Abbottabbad, when the Ayub Teaching Hospital outbreak is, and about 100 miles from Dir where the unknown outbreak (possible dengue) is, according to Google Maps.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

This article confirms that there were indeed 3 CCHF patients treated at HFH. 2 have died, and one (Rasheeda) was transferred and recovered.

http://www.thenews.com.pk/01-10-2010/islamabad/7658.htm

2 die of Viral Hemorrhagic Fever at HFH



Muhammad Qasim
Rawalpindi
A suspected female patient of Crimean-Congo Haemorrhagic Fever died of the infection at Holy Family Hospital in the night between Wednesday and Thursday.
The female patient Tahira, aged 42, was brought to the HFH from Chakwal on Wednesday evening with complaints of high-grade fever and bleeding from nose, mouth and skin, apparently the symptoms of CCHF. The HFH administration after suspecting the patient a case of CCHF sent her blood sample to National Institute of Health, Islamabad for confirmation, however, the patient died at midnight before confirmation reports regarding her status from the NIH.
?Apparently, Tahira was a patient of CCHF, however, the NIH would give us report regarding her status in actual,? said official spokesman of HFH Dr. Raja Shafiq Sarwar while talking to ?The News? Thursday.
?The News? also learnt that a confirmed patient of CCHF Tofeeq, aged 30, who was a resident of Pindigheb died of the infection at HFH on September 24. Dr. Shafiq has also confirmed the news regarding death of Tofeeq due to CCHF.
It is important that another confirmed patient of the CCHF, Rasheeda Begum, aged 35, moved to Shifa International Hospital on September 16 from HFH. Rasheeda who got better at Shifa and has been allowed to go home belongs to Village Toot, Dhoke Golguppa of Tehsil Pindigheb, Attock.
On Wednesday, NIH declared seven health professionals including four lady doctors and three nurses serving at HFH positive for CCHF. It is learnt that the infected health professionals who have not developed symptoms of the CCHF so far were involved in treatment of the CCHF cases.
Dr. Shafiq said that the hospital staff was not infected because of the negligence while handling suspected CCHF cases instead it happened because of dedication of the staff towards provision of treatment facilities to patients. ?When a patient reaches hospital with high-grade fever, the hospital staff gets busy in providing treatment to the case while the confirmation report regarding status of the patient and type of the fever takes time,? he explained.
To a query, he added that the hospital administration has issued directives to the hospital staff to wear masks and gloves before examining any patient of high-grade fever. ?Also we are extending existing isolation ward at the HFH to accommodate greater number of suspects of viral hemorrhagic fevers.?
Meanwhile, in recent past, nearly 50 suspected cases of Dengue fever reached HFH of which four were confirmed positive. ?The confirmed patients of Dengue fever have been discharged from HFH after achieving complete cure,? said Dr. Shafiq.
Officiating Director Health Services, Rawalpindi Division and District Health Officer Dr. Khalid Randhawa when contacted said that his department has taken all necessary measures to control CCHF and dengue fever viruses. ?So far not a single case of Dengue fever has been reported from Rawalpindi,? he said.
He added that the four confirmed cases of Dengue fever were brought to the HFH from Chakwal. ?The executive district officer (health) Chakwal asked me to provide fogging machine that we have given to him however I have asked him to arrange a fogging machine on his own for permanent use,? he said.
He added that in response to a request by the HFH administration, he has arranged limited spraying of insecticidal residual spray in the high-risk places of the hospital for prevention from dengue fever.
To a query, he said that not a single patient of dengue fever has so far died of the infection. He, however, confirmed death of Tofeeq due to CCHF at HFH who was taken from Pindigheb.
On CCHF, he claimed that his office is on vigilant surveillance. ?We are in contact with all family members of Rasheeda?s family and have arranged their examination on daily basis at least for 14 days, the incubation period of the CCHF.?
Rasheeda?s brother Fateh Khan, when contacted, said that Rasheeda has been discharged from Shifa International Hospital. ?She is getting better at home,? he said.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

It seems there may be a large CCHF outbreak in Pindi Gheb, and there seems to have been at least four fatalities from there. The timing of this many cases at once suggests either exposure to the first couple patients, or the mass consumption of an infected animal.

http://www.dawn.com/wps/wcm/connect...go-fever-suspects-land-in-pindi-hospitals-100

15 more Congo fever suspects land in Pindi hospitals By Aamir Yasin
Friday, 01 Oct, 2010 DAWN CLICKS
The four-step guide to easy land reclamation RAWALPINDI, Sept 30: The city hospitals on Thursday received 15 patients with symptoms of deadly Crimean-Congo Hemorrhagic Fever (CCHF) from Chakwal and adjoining areas.

Eleven patients were admitted to Holy Family Hospital and two each to District Headquarters (DHQ) Hospital and Benazir Bhutto Hospital. The doctors said that they had been suffering from fever for the last six days and some of the patients’ gums had started to bleed.

They said that the doctors suspected them as patients of Crimean-Congo Hemorrhagic Fever. They were shifted to intensive care unit (ICU) and their blood samples were dispatched to National Institute of Health (NIH) for test for Crimean-Congo Hemorrhagic Fever and dengue.

They said that the hospitals would receive the blood test report on Friday and if the patients tested positive for the disease the doctors would start to provide them medication in isolation room.

Doctors at Holy Family Hospital said that as many as seven patients came from tehsil Dhudyal, Chakwal; one patient from Chakwal city and the rest from Rawalpindi city.

They said that two patients with symptoms of dengue and CCHF also came to hospital from Chakwal but they expired on Wednesday night. They said that the dead were handed over to their families on Thursday morning.

Talking to Dawn, Dr Javed Hayat of Holy Family Hospital said, “the patients have been kept under observation at ICU and their treatment will start as soon as the hospital receives their blood test report.”

Replying to a query about the staff of the hospital that contracted the Congo virus, Dr Hayat said that their condition was stable and they were being provided all available medical treatment. He said, “Though the blood tests of the doctors were positive, but the symptoms have not appeared.”

The Benazir Bhutto Hospital medical superintendent, Dr Asif Qadir Mir, said that the blood samples of two patients had been sent to NIH and they would receive report on Friday.

District headquarters hospital medical superintendent Dr Sher Ali Khan also confirmed that there were two patients in the hospital and the doctors suspected them as cases of CCHF. He said that the medical treatment of the patients would be started after they received reports from NIH. However, he said that the doctors were monitoring the condition of the patients in isolation ward.
If you want to follow news on your mobile, click on http://dawn.com/mobile/ and download Pakistan's first mobile news application. Currently this application is for Nokia phones only

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85109

Archive Number 20101001.3563
Published Date 01-OCT-2010
Subject PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (04): (PB)


CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (04): (PUNJAB)
*********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 1 Oct 2010
Source: newdawn.com Islamabad [edited]
<http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/the-newspaper/local/islamabad/15-more-congo-fever-suspects-land-in-pindi-hospitals-100>


More Crimean-Congo fever suspects land in Pindi hospitals
---------------------------------------------------------
The city hospitals on Thursday [30 Sep 2010] received 15 patients with
symptoms of the deadly Crimean-Congo haemorrhagic fever (CCHF) from
Chakwal and adjoining areas. A total of 11 patients were admitted to
Holy Family Hospital (HFH) and 2 each to District Headquarters (DHQ)
Hospital and Benazir Bhutto Hospital. The doctors said that [the
patients] had been suffering from fever for the last 6 days and some
of the patients' gums had started to bleed.

They said that the doctors suspected them to be patients with CCHF.
They were shifted to the intensive care unit (ICU) and their blood
samples were dispatched to the National Institute of Health (NIH) for
testing for CCHF and dengue fever. They said that the hospitals would
receive the blood test report on Friday [01 Oct 2010] and if the
patients tested positive for the disease the doctors would start to
provide medication in an isolation room.

Doctors at Holy Family Hospital said that as many as 7 patients came
from tehsil [administrative zone] Dhudyal, Chakwal; one patient from
Chakwal city and the rest [5] from Rawalpindi city. They said that 2
patients with symptoms of dengue and CCHF also came to hospital from
Chakwal but they expired on Wednesday night [29 Sep 2010]. They said
that the dead were handed over to their families on Thursday morning.
Talking to Dawn, Dr Javed Hayat of Holy Family Hospital said, "the
patients have been kept under observation in an ICU and their
treatment will start as soon as the hospital receives their blood test
report."

Replying to a query about the staff of the hospital who had contracted
the CCHF, Dr Hayat said that their condition was stable and they were
being provided with all available medical treatment. He said, "Though
the blood tests of the doctors were positive, no symptoms have
appeared."

The Benazir Bhutto Hospital medical superintendent, Dr Asif Qadir Mir,
said that the blood samples of 2 patients had been sent to the NIH and
they would receive a report on Friday [01 Oct 2010].

DHQ hospital medical superintendent Dr Sher Ali Khan also confirmed
that there were 2 patients in the hospital and the doctors suspected
them to be cases of CCHF. He said that the medical treatment of the
patients would be started after they received reports from the NIH.
However, he said that the doctors were monitoring the condition of the
patients in an isolation ward.

[Byline: Aamir Yasin]

--

[If all of the suspected cases are confirmed by laboratory diagnostics
this outbreak will prove to among the largest outbreaks of CCHF
recorded in Pakistan. In addition to the nosocomial infections in the
HFH hospital in Rawalpindi, suspected patients are being referred from
different parts of Punjab province. The routes of exposure of these
patients and their occupations have not been disclosed.

Under normal conditions CCHF infection is restricted mainly to those
involved with the livestock industry, such as agricultural workers,
slaughterhouse workers and veterinarians. It may be that the recent
disastrous flooding in the Indus valley has exposed humans to direct
infection from the _Hyalomma_ tick vector of CCHF virus. The most
important source for acquisition of CCHF virus by ticks is believed to
be the small vertebrates on which immature _Hyalomma_ ticks feed.

Further information is awaited on the outcome of the diagnostic tests
now in progress.

A map of Punjab province can be accessed at:
<http://pamirtours.pk/maps/punjab%20map.htm>, and the
HealthMap/ProMED-mail interactive map of Pakistan is available at
<http://healthmap.org/r/00tj>. - Mod.CP]

[Given the high index of suspicion of CCHF in these cases, it seems
dangerous to postpone treatment until the results of the blood tests
are known. One hopes that the families to whom the the expired
patients are returned have been told of the danger of contact with
their blood or excretions. It is again unclear whether the medical
staff in Holy Family Hospital are symptomatic or merely in isolation
under observation. - Mod.JW]

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Tahira's death will remain as a probable CCHF fatality and cannt be confirmed because there is no sample to test. Given that she comes from the same village as two confirmed cases, her case is highly probable.

It is not clear what tests run on the HCW returned positive results, but none of them seem to have taken ill, and the incubation period may have run out.

http://www.thenews.com.pk/02-10-2010/islamabad/7746.htm

HFH takes preventive steps against Congo Fever



Muhammad Qasim
Rawalpindi
The Holy Family Hospital administration claimed on Friday that it has adopted a new protocol provided to it by the National Institute of Health (NIH) after the death of two victims of Viral Hemorrhagic Fever at the HFH during last one week.
A confirmed patient of the Crimean-Congo Hemorrhagic Fever (CCHF), Taufeeq, aged 30, who was brought to the hospital from Pindigheb on September 20, died of the infection at the HFH on September 24. Another suspected case of CCHF, Tahira, aged 42, died at the HFH in the night between September 29 and 30.
Tahira was brought to the HFH from Chakwal in the evening of September 29 with complaints of high-grade fever and bleeding from nose, mouth and skin, apparently the symptoms of CCHF.
?The News? learnt that Tahira stayed at the HFH for more than four hours before her death, however, the hospital staff involved in her treatment failed to get her blood sample needed to be tested at the NIH to have the exact type of fever with which she was suffering.
Earlier, a confirmed patient of CCHF, Rasheeda Begum, aged 35, moved to the Shifa International Hospital on September 16 after staying for two days at the HFH. Rasheeda, who got better, has been discharged by the Shifa International Hospital, however, four lady doctors and three nurses who were involved in her treatment at the HFH have been infected with the CCHF virus. The NIH declared seven health professionals positive for CCHF on September 29, however, none of them developed any symptoms of the highly infectious disease.
?The infected health professionals were involved in treatment of CCHF confirmed patient Rasheeda more than 14 days back and at present they are absolutely fit medically so they are safe,? said HFH official spokesman Dr. Raja Shafiq Sarwar while talking to ?The News? here on Friday.
It is important that immediate (close) family members, attendants and medical staff involved in treatment of a CCHF patient might be at risk if proper preventive measures are not taken. Studies reveal that a person after getting infected with the disease-causing virus generally develops signs and symptoms of the CCHF within 15 days and if that does not happen, the disease is unlikely to occur in that person.
To a query, Dr Shafiq said that the hospital administration, however, has decided to keep all the hospital staff serving at the HFH medical unit under strict surveillance, as they were involved in treatment of confirmed CCHF patient, Taufeeq and the VHF case of Tahira.
In-charge Infection Control Committee at HFH Dr. Javed Hayat, when contacted by ?The News? said that the medical staff involved in treatment of Tahira could not collect her blood sample for testing, as they spent the whole time with Tahira in managing her.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

http://www.dawn.com/wps/wcm/connect...nother-suspected-congo-fever-patient-dies-300

Another suspected Congo fever patient dies By A Reporter
Sunday, 03 Oct, 2010 PAKISTAN AT CWG
Pakistan?s A-team has gold in sight RAWALPINDI, Oct 2: Another suspected woman patient of Crimean-Congo Haemorrhagic Fever (CCHF) died at District Headquarters (DHQ) Hospital on Saturday.

Misbah Ahmed, 30, was brought to DHQ Hospital from Imambargah Mohallah near Jamia Masjid Road on Thursday with complaints of high fever and bleeding from mouth, apparently the symptoms of CCHF.

DHQ Medical Superintendent Dr Sher Ali Khan said the doctors after suspecting the patient as a case of CCHF or dengue, dispatched the blood samples to National Institute of Health (NIH) for confirmation. However, he said the patient died on Saturday morning. ?We would not declare her a patient of CCHF or dengue without the confirmation of NIH.?

He said the report would be received on Monday and if it confirmed positive for the virus, the administration would send the blood samples of doctors and nurses who are dealing the patient for test at NIH.

Earlier two confirmed CCHF patients died at the Holy Family Hospital (HFH), forcing the doctors and nurses take preventive measures. Tahira, 42, from Chakwal, and Tofeeq, 30, from Pindigheb, died of the infection at HFH during the last two weeks.

More than 14 other suspected patients of CCHF were admitted in the hospital. However, the condition of four doctors, three nurses, and a ward boy is stable whose tests were confirmed positive for the CCHF.

When contacted, Dr Javed Hayat of HFH, said the suspected patients of CCHF were under observation and their test report from NIH was expected on Monday (tomorrow).

Talking to Dawn, Prof Dr Abbas Hayat, head of pathology department, Rawalpindi Medical College, called for urgently taking preventive steps. He said CCHF was first reported in Pakistan in 1976, and since then the country has usually experienced up to 60 cases annually, mostly in Balochistan and Khyber Pakhtunkhwa. He said the suspected patients were with sudden onset of illness with high fever over 38.5 C for more than 72 hours and less than 10 days, especially among those in contact with sheep or other livestock.

Dr Hayat said the hospitals should maintain stock of Ribavirin, available in Pakistan. He said pregnancy should be absolutely prevented within six months of completing a course of Ribavirin.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

http://tribune.com.pk/story/57850/two-children-suspected-of-congo-fever/

RAWALPINDI: Two children, suspected of being infected by the deadly Congo Fever virus, were brought to the Holy Family Hospital on Saturday evening.

Two well-placed sources inside the hospital confirmed that a three-year-old boy and an eight-year-old girl Natasha, from two different families in Chakwal, were admitted to the hospital?s isolation ward.

They added that blood samples of the two children had been sent to the National Institute of Health (NIH) to test for Congo Crimean Hemorrhage Fever (CCHF).

Dr Raja Shafiq, Director Holy Family Emergency Ward, however said that he was not aware of the two patients. ?No such patient was brought to the hospital during my shift,? he said.

Earlier, according to Dr Shafiq, one of the two patients infected by the same deadly virus had died.

The other patient, he said, was shifted to a private hospital.

After the death, the hospital administration had decided to send samples of its entire staff to NIH to test for Congo Fever virus. While all ICU staff had been cleared, seven other hospital staff had tested positive.

After four days of treatment however, the hospital decided to resend their blood samples to NIH. ?The [original] test results are doubtful because we did not find any symptoms of Congo Virus in [the seven staff members] after four days,? Dr Shafiq said.
Published in The Express Tribune, October 3rd, 2010.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

It appears that many of the suspect CCHF cases from Chakwal have been confirmed as dengue.

http://www.thenews.com.pk/05-10-2010/islamabad/8314.htm

Dengue fever spike likely to hit Rawalpindi region



Muhammad Qasim
Rawalpindi
Health experts have started fearing an outbreak of dengue fever in the city after reports of confirmation of at least 12 cases of the infection at the Holy Family Hospital (HFH).
?The News? learnt that a total of 64 suspect cases of dengue fever have been reported at the HFH during last three weeks. Out of them, 12 cases have been confirmed positive for the infection by the National Institute of Health, Islamabad.

snip

?The number of suspect cases of dengue fever coming to the HFH is on the rise,? said HFH Spokesman Dr. Raja Shafiq Sarwar while talking to ?The News? here on Monday. He claimed that the HFH administration is well prepared to deal with any untoward situation if occurs due to spread of dengue fever in the city.
?We are already working on extension of isolation ward at the hospital to keep patients reaching the hospital with any type of viral haemorrhagic fevers, including dengue fever and Crimean-Congo Haemorrhagic Fever,? he said.
Two patients of viral haemorrhagic fevers, including a confirmed case of CCHF and a suspected case of CCHF, died at the HFH during last 10 days. A confirmed case of the CCHF namely Tofeeq, aged 30, who died at the HFH on September 24, was brought to the hospital from Pindigheb, while the suspected case of CCHF, Tahira, aged 42, who died on September 29, was a resident of Chakwal.
In-charge Infection Control Committee at HFH Dr. Javed Hayat said on Monday that the hospital has so far received 12 confirmed cases of dengue fever. According to statistics, the HFH received 14 suspected cases of dengue fever during last four days, of which, eight have been confirmed positive for the infection.


more at above link.....

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

http://www.thenews.com.pk/06-10-2010/islamabad/8465.htm

[snip]

The data collected by ?The News? revealed that the number of suspected cases of viral haemorrhagic fevers being reported at HFH is continuously on the rise. ?Within past 48 hours, we have received 25 suspected cases of dengue fever whose blood samples have been sent to National Institute of Health, Islamabad for dengue serology,? said official spokesman of the hospital Dr Raja Shafiq Sarwar while talking to ?The News? on Tuesday.
He said that the HFH received 82 suspects of dengue fever this season of which only five were confirmed positive by the NIH. ?All the five confirmed cases of the infection have been discharged after treatment,? he said.
To a query, Dr Shafiq informed ?The News? that so far not a single case of dengue fever was reported from within town. ?All cases confirmed so far were from other districts including Chakwal.?
He, however, added that of 25 cases suspected recently for dengue fever, a few are from within town. ?However, we are waiting for their status from the NIH.?
Incharge Infection Control Committee at HFH Dr Javed Hayat informed that a total of 12 cases of CCHF have been reported at HFH within past three weeks of which two died at the hospital.
Giving details of the cases, he revealed that a total of nine employees of the hospital including four lady doctors, three nurses and two ward boys were infected by the CCHF virus when two confirmed cases of the CCHF were undergoing treatment at the hospital.
It is important that a confirmed patient of Crimean-Congo Hemorrhagic Fever Tofeeq, aged 30 who was brought to the hospital from Pindigheb on September 20 died of the infection at HFH on September 24 while a suspected case of CCHF, Tahira, aged 42 died at HFH in the night between September 29 and 30.
Earlier, a confirmed patient of CCHF, Rasheeda Begum, aged 35 moved to Shifa International Hospital on September 16 after staying for two days at HFH.
To a query, Dr Javed Hayat said that the hospital administration did not cover the dead body of Tofeeq, the confirmed case of CCHF, while handing it over to his family. Health exerts globally agree that the dead body of a victim of CCHF should be wrapped up with plastic sheets as a precautionary measure to save the family of the victim from exposure to virus if that is in his body.
Dr Shafiq Sarwar, however, when asked said that there was no need of wrapping up dead body of the CCHF victim, Tofeeq.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

I'm confused...perhaps this is an echo story, or just a bad source. It is also possible that someone is trying to cover-up what has already been admitted.

http://pakobserver.net/detailnews.asp?id=55729

NIH denies congo virus presence
Islamabad—National Institute of Health (NIH) said that not a single test of deadly Crimean-Congo Haemorrhagic Fever (CCHF) virus has been reported positive during the last two months.

According to an official of NIH Epidemic Investigation Cell, several blood samples were received by the institute from various parts of the country on suspicious of congo virus however all such tests were declared negative after investigation.

He said unfortunately when patient visits to hospital with symptoms like dripping of blood from nose, mouth and in urine, doctors immediately consider such patient as congo affected and avoid to provide medical treatment.

He added it is not necessary that any patient with dripping of blood could be affected from congo virus and said that doctors should properly treat such patient and wait for results of blood samples. He said even certain deaths occurred in hospitals due to refusal of doctors for treatment of suspected patients with congo virus symptoms.

He however said that when a confirmed patient with CCHF is admitted to hospital, there is a risk of nosocomial spread of infection. It is imperative that adequate infection control measures should be observed to prevent this disastrous outcome, he added.

He said patients with suspected or confirmed CCHF should be isolated and cared for using barrier nursing techniques, adding, specimens of blood or tissues taken for diagnostic purposes should be collected.—APP

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

http://www.thenews.com.pk/07-10-2010/islamabad/8673.htm

History?s biggest outbreak in a hospital



Muhammad Qasim
Rawalpindi
The confirmation of 12 cases for Crimean-Congo Hemorrhagic Fever reported at Holy Family Hospital during last three weeks is the biggest outbreak of the infection in the history in a hospital but still the concerned government authorities are not taking the matter as seriously as it is.
The guidelines issued by the National Institute of Health, Islamabad, on monitoring, prevention, public education and safe burial practices in case of death of a CCHF victim are not being followed in letter and spirit.
Rawalpindi Medical College Department of Pathology Head Professor Dr. Abbas Hayat expressed these views while talking to ?The News? here on Wednesday.
He said that confirmation of nine health officials serving at the Holy Family Hospital for CCHF is the biggest outbreak at a healthcare facility in the history of the infection.
To a query, he said that the situation has already become alarming and for prevention, there is a dire need for creating sufficient awareness among the public and even health professionals who unfortunately have little knowledge about different aspects of the deadly infection.
Studies reveal that the CCHF is caused by Nairovirus of the Bunyaviridae family transmitted to humans by the bite of Hyalomma tick or by direct contact with blood of an infected animal or human. The case fatality rate ranges from 2% to 50%. The CCHF was first described in Crimea in 1944 and identified in 1956 in Congo.
Dr. Abbas Hayat said that many species of mammals can transmit CCHF virus to ticks when they are viremic. Small vertebrates such as hares and hedgehogs, which are infested by immature ticks, may be particularly important as amplifying hosts. With a few exceptions, most migratory birds coming down the plains as winter snowfall starts on the hills, may carry these ticks.
Birds seem to be refractory to infection; however, they may act as mechanical vectors by transporting infected ticks. Migratory birds might spread the virus between distant geographic areas, he said.
Dr. Hayat added that humans become infected through the skin and by ingestion. Aerosol transmission was suspected in a few cases in Russia. Sources of exposure include being bitten by a tick, crushing an infected tick with bare skin, contacting animal blood or tissues and drinking unpasteurised milk. Human-to-human transmission occurs, particularly when skin or mucous membranes are exposed to blood during haemorrhages or tissues during surgery. CCHFV is stable for up to 10 days in blood kept at 40?C (104?F). Possible horizontal transmission has been reported from a mother to her child.
He said that the CCHF virus can very easily be killed by 1% hypochlorite commonly used as household bleach and 2% glutaraldehyde. It is also destroyed by heating at 56?C (133?F) for 30 minutes.
Talking of the incubation period, he said that the incubation period is influenced by the route of exposure. Infections acquired via tick bites usually become apparent after one to three days; the longest incubation period reported by this route is nine days. Exposure to blood or tissues usually results in a longer incubation period. Current estimates suggest that these infections become apparent, on average, after five to six days, but incubation periods up to 13 days are also known.
It is important that a total of nine health officials at HFH including four lady doctors, two staff nurses, one student nurse and two ward boys were infected by the CCHF virus when two confirmed cases of the CCHF were undergoing treatment at the hospital two weeks back, however none of them developed signs and symptoms of the infection even after passage of 14 days.
When asked, Dr. Hayat said there might be chances of error in their testing done at the NIH. ?The NIH should repeat tests of the nine health officials,? he said. ?The News? learnt that the nine infected health officials have not been given proper care and attention that should have been done as a precautionary measure.
On signs and symptoms, Dr. Abbas Hayat said that the first sign of CCHF is a sudden onset of fever and other non-specific symptoms including chills, severe headache, dizziness, photophobia, neck pain, myalgia (muscular pains) and arthralgia (joint pains). The fever may be very high. Gastrointestinal symptoms including nausea, vomiting, non-bloody diarrhoea and abdominal pain are also common. Sharp mood changes, confusion and aggression have been reported in some cases. Cardiovascular changes such as bradycardia (slowing of heartbeat) and low blood pressure can also occur. This early stage of disease is called the pre-hemorrhagic phase. It is followed, after several days, by the hemorrhagic phase.
He added that the hemorrhagic phase develops suddenly. It is usually short, lasting on average two to three days. A petechial (bleeding tendency) rash may be the first symptom. The rash is followed by petechiae (bruises), ecchymoses (skin blotches) and large bruises on the skin and mucous membranes. Hematemesis (blood in vomiting), melena (blood in stool), epistaxis (nasal bleeding), hematuria (blood in urine), hemoptysis (blood in sputum) and bleeding from venipuncture sites (spots around the site from where venous blood is withdrawn) are also common. Bleeding can occur in other locations, including the brain. In one case, internal bleeding mimicked acute appendicitis. Hepatitis occurs in some patients, and may result in jaundice and hepatomegaly (enlargement of liver). Splenomegaly (enlargement of spleen) can also be seen. Some patients die from hemorrhages, hemorrhagic pneumonia or cardiovascular disturbances, explained Dr Abbas.
To a query, he said that in patients who survive, recovery begins 10 to 20 days after the onset of illness. The convalescent phase is characterised by generalised weakness, a weak pulse and tachycardia (rapid heartbeat). Other symptoms including sweating, dryness of the mouth, headache, dizziness, nausea, poor appetite, laboured breathing, polyneuritis, poor vision, loss of hearing, and memory loss have also been seen. Some patients temporarily lose all of their hair.
He added that from affected patients; haemorrhages are an important source of exposure for other people, particularly family members and healthcare workers. ?Possible horizontal transmission has been reported from a mother to her child.?
He said that in case of death of a CCHF victim, safe burial practices must be followed to avoid spread of the infection. According to the NIH guidelines, thick and long rubber gloves or double pair of surgical gloves should be used for washing the body for burial. The dead body should be sprayed with 1:10 liquid bleach solution and then placed in a plastic bag, which should be sealed with adhesive tape. It should then be wrapped in the winding sheet (kafan) for burial. Disinfect the transport vehicle by spraying 1:10 liquid bleach solution on any surfaces touching the body and burn all clothing of the deceased, said Dr Abbas.
It is, however, important that the HFH administration did not cover the dead body of Tofeeq, the confirmed case of CCHF, while handing it over to his family on September 24 that according to health experts amount to put hundreds of lives at stake.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

This source is being mildly sloppy - there are/were apparently 11 individuals in HFH who have tested positive for CCHF virus (including the nine HCW who are asymptomatic, possibly as a result of prophylactic ribavirin), plus one fatality that died without samples being taken.

Only the 9 HCW are still in the hospital - one of the other two cases has been discharged and the other has died.

http://www.dawn.com/wps/wcm/connect...ad/eight-more-dengue-suspects-land-in-hfh-700

Eight more dengue suspects land in HFH By Aamir Yasin
Thursday, 07 Oct, 2010 MEDIA GALLERY
In the mind?s eye RAWALPINDI, Oct 6: Eight more suspected dengue fever patients were on Wednesday admitted to the Holy Family Hospital (HFH), raising the number to 26.

However, the National Institute of Health (NIH) confirmed that only five of them were suffering from dengue fever.

The HFH has not established an isolation centre for the patients diagnosed with dengue and Crimean-Congo Haemorrhagic Fever (CCHF). The hospital keeps such patients in a separate ward adjacent to the emergency unit.

Sources told Dawn that the hospital administration had not started fumigation in the building even after the death of a CCHF patient, identified as Touseeq, on September 24.

According to sources, a total of 90 patients were brought to HFH during the last three weeks with symptoms of dengue fever. The HFH administration sent blood samples of 56 of the patients to NIH which said five of them had tested positive for dengue fever.

Doctors said the 26 suspected patients admitted to the hospital were under observation, adding the five infected persons kept in quarantine were diagnosed with high fever, vomiting and shivering. They said if proper measures like fumigation and spray of insecticides were not taken immediately, the infection could assume an endemic proportion.

Talking to Dawn, Dr Javed Hayat of HFH confirmed that five of the patients had tested positive for dengue fever. He said the patients had been put in an isolation ward.

Dr Hayat said patients with confirmed and presumed cases would be no longer infectious because the virus stayed in the patient?s blood stream for a week after developing the symptoms.

In reply to a question, he said most of the dengue patients belonged to Chakwal. However, he refused to reveal the names and details of the patients. ?Legally, we are bound to tell problems of the patients to their relatives only and we would not want to create panic in the area from where the patients have come,? he said.

When asked about CCHF confirmed and suspected patients, Dr Hayat said total 12 confirmed patients of CCHF were admitted to Holy Family Hospital including four doctors, three nurses and two ward boys.

He said condition of the Congo patients was stable and they would recover soon. He said they had been providing medicines to the patients for the last 12 days and would complete the course.

Doctors said dengue fever is a viral infection caused by female mosquito Aedes Aegypti and lasts for approximately seven days despite its sudden and acute onset.

Dengue viruses are transmitted to humans through the bites of the female mosquito. This variety of mosquito breeds easily during the rainy seasons but can flourish in fresh water stored in plastic bags, cans, flowerpots and old tyres.

When contacted, HFH spokesman Dr Raja Shafiq Sarwar said the hospital administration had adopted all possible universal infection control measures.

He said the suspected and confirmed patients had been isolated and some of them put on high alert.

He said the HFH administration would establish an isolation centre in the basement of its medical ward from Thursday. He said a total of 50 beds would be allocated in the isolation centre as the number of dengue and Congo fever patients was increasing.

He said doctors and paramedical staff had been provided medical gloves, masks and other necessary items to prevent them from the viral diseases.

 

[Giuseppe]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

From latest weekly WHO Epidemiological Update: http://www.who.int/hac/crises/pak/sitreps/pakistan_epi_4october2010.pdf

27‐Sep‐10 - DHF - Ayub Teaching Hospital/Abbottabad - KPK - Tragic death of medical doctor confirmed due to CCHF. 14 contacts tested negative for both CCHF and Dengue. 8 samples were reported to be positive for Dengue in private labs.

(...)

Crimean-Congo Hemorrhagic Fever (CCHF)

Of three cases testing positive for CCHF in the past month, two have died, and an additional seven have become infected by nosocomial transmission at a Rawalpindi hospital. In Pakistan, the incidence of CCHF peaks in June and October but cases occur throughout the year.

Similar to Dengue Hemorrhagic Fever (DHF), CCHF presents as a fever of 2‐7 days which does not respond to antibiotics or anti‐malarial treatment and is associated with dropping platelets and hemorrhagic signs with case fatality rate as high as 50%. Two main differences are that CCHF is transmissable from the blood of patients with the disease, and it is successfully treated with high dose Ribavirin, while DHF does not respond to antivirals and it is not transmissable directly from the patient.

 

[alert]

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

Re: Nosocomial CCHF Cluster In Punjab, Pakistan

This is an errant source. There have been 12 (probable) cases, of whom only two have died, not 12 deaths.

http://www.onlinenews.com.pk/details.php?id=169593

Congo virus: Health ministry unaware of 12 deaths
ISLAMABAD: Health Ministry turns out to be unaware of 12 deaths due to Crimean-Cango Hemorrthagic Fever (CCHF) known as Congo virus.

12 people among 9 health officials in Holy Family hospital Rawalpindi have been killed due to this virus.

Responding to question raised in National Assembly in this regard Parliament Secretary for Health Mehreen Razzaq Bhutto said that ministry of Health is unaware of deaths in such large numbers by CCHF and she could answer the question after getting information in this regard.

She said that the deaths might be due to dengue virus as symptoms of CCHF and dengue are similar

Answering to question regarding drugs import she said that last year drugs worth of $ 387 million were imported while drugs import bill for fiscal year 2005-06 was $ 196 million.